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APPEALS COURT SKEPTICAL OF BIRTH CONTROL MANDATE — Judges on the 7th Circuit Court of Appeals pushed back strongly on the Obama administration as it appeared in an appeals court for the first time to defend its birth control coverage mandate. A three-judge panel heard back-to-back arguments in cases brought by two for-profit businesses in which the owners say their Catholic beliefs prohibit them from providing coverage of contraceptives and other drugs that they say can cause abortions. The oral arguments represented the first time one of the approximately 30 lawsuits brought by a for-profit firm against the coverage requirement went to an appeals court. There are about 30 other lawsuits brought by nonprofit institutions against the same mandate. One judge said that if a company and its leaders can be held liable for their business decisions, they should also have some rights — like the right to not provide access to products they find objectionable on religious grounds. The POLITICO Pro story: http://politico.pro/13JN1Bb

Happy Thursday and welcome to PULSE, where we often like to ponder serious health policy questions, like this one: With news of NASA trying to develop a 3-D pizza printer, would printed pizza also count as a vegetable (http://politi.co/uim8Mi)?

“I got a PULSE that keeps me waiting”

TODAY ON POLITICO PRO:

--IOWA REACHES DEAL ON MEDICAID EXPANSION — Iowa lawmakers and Gov. Terry Branstad reached an agreement yesterday on accepting federal dollars for the Medicaid expansion. Iowa residents earning up to 100 percent of the federal poverty line would be enrolled in the traditional Medicaid program, while those earning between 100 percent and 138 percent FPL would be enrolled in the exchange with Medicaid expansion dollars. http://politico.pro/169nU1U

--ECONOMIST: GOOD TIMES WON’T LAST — A prominent health economist says the recent slowdown in health care spending probably isn’t here to stay. Weighing in on the debate over what’s causing the slowdown, Stanford economist Victor Fuchs says we probably have the recession to thank — and not systemic changes that would indicate a slowdown with more staying power. http://politico.pro/13JNYcX

OKLAHOMA’S SUBSIDY LAWSUIT GETS A HEARING DATE — A federal judge in Oklahoma has scheduled a June 20 hearing on the Obama administration’s request to throw out the state’s challenge to the IRS rule on exchange subsidies, the Tulsa World reports. Oklahoma’s lawsuit accuses the IRS of exceeding its authority when it ruled federal exchanges could deliver subsidies to purchase exchange coverage — the state and ACA opponents claim the law only allows subsidies in state-run exchanges. The Tulsa World story: http://bit.ly/ZeCKkA

HOUSE NEGOTIATOR: OBAMACARE COULD RUIN IMMIGRATION DEAL — A House Republican negotiator warned yesterday that the health care law could singlehandedly ruin a shot at comprehensive immigration reform. “What might be the story at the end of this year, at the end of this session, is that Obamacare killed immigration reform,” Rep. Raul Labrador said Wednesday. Republicans are adamant that no public dollars be used to cover health care for the estimated 11 million undocumented immigrants, and House negotiators have been hung up on health care language in the immigration bill. The POLITICO story: http://bit.ly/13JiHXo

** Pfizer Helpful Answers is a family of prescription assistance programs that provides eligible patients with their Pfizer prescriptions for free or at a savings, and offers reimbursement support services for select products. www.PHAHelps.com **

DEVICE MANUFACTURE PLEADS FIFTH AT HILL HEARING — Lois Lerner, you’ve got company. A medical-device company president yesterday also invoked his Fifth Amendment right against self-incrimination amid allegations his firm defrauded Medicare for millions of dollars. Jon Letko of U.S. Healthcare Supply refused to answer questions during a Senate subcommittee hearing yesterday, while a representative of another medical-device maker accused of fraud, Med-Care Diabetic & Medical Supplies, agreed to talk. Sen. Claire McCaskill (D-Mo.), who chairs the subcommittee, said both firms were accused of using overly aggressive marketing tactics — an area she’ll probe further. U.S. Healthcare Supply wrote a letter questioning the subcommittee’s findings, while Med-Care testified CMS never asked the company to make repayments. The Pro story: http://politico.pro/1a8aO1k

RUBIO: MORE IRS HEARINGS, PLEASE — Sen. Marco Rubio (R-Fla.) is calling for more hearings on the IRS’s targeting of conservative groups, in part because of the agency’s major role in overseeing Obamacare. “The agency [the White House] is accusing of incompetence happens to be on the front lines of implementing Obamacare,” Rubio told Fox News last night. “They’re going to hire 2,000 new agents. They’re going through the personal medical history of Americans.” More from Rubio: http://politi.co/12WWWV7

SEBELIUS’S MESSAGE TO GRADUATES — There’s still no word from HHS whether Secretary Kathleen Sebelius will deliver any commencement speeches this year, after giving at least one each previous year she’s held the job. In the meantime, though, Sebelius took to the Huffington Post yesterday to offer a graduation message that basically could boiled down to this: “Congrats! Go get health insurance, which is awesome now thanks to the ACA.” OK, it was a little more eloquent than that, but you get the idea. Her pitch to the Class of 2013: http://huff.to/13Lsekk

POLITICO PRO TO LAUNCH ‘CEO REPORT’ IN JUNE: POLITICO Pro’s latest newsletter, “CEO Report,” will debut next month. Written by POLITICO Playbook’s Mike Allen and Pro Editor Martin Kady II, the once-a-month feature will offer executives and policy professionals an exclusive summary of the most important policy debates. CEO Report’s easy-to-read, forward-looking format is designed to get you up to speed without having to sort through the daily minutia of Washington policy. Interested in receiving CEO Report? Become a Pro today: https://www.politicopro.com/proinfo/

CALIFORNIA RATES COMING TODAY — A day after Colorado posted proposed 2014 health insurance rates, California will make its big reveal today. Leaders of Covered California, the state’s exchange, are scheduled to address the media at 9 a.m. local time.

MEDICAID EXPANSION CLUES IN UTAH? — Consumer advocates in Utah are expecting today to see a long-awaited cost-benefit analysis of the Medicaid expansion commissioned by Gov. Gary Herbert’s administration. The report won’t be the determining factor for the expansion in Utah — Herbert is expected to announce his decision around September after a study group finishes its work — but advocates think the report will bolster the case for expansion.

MEANWHILE, MICHIGAN GOV STILL HOPEFUL ON EXPANSION — Michigan Gov. Rick Snyder, a Republican governor who announced his support for the expansion months ago, told the Associated Press yesterday he’s still “hopeful” that he and fellow Republicans in the Legislature can work out a deal. Snyder, who met with Obama administration officials yesterday on Medicaid, earlier this week reached a tentative budget agreement with lawmakers that didn’t include the expansion. From the AP: http://bit.ly/16QotOc

PRO EVENT: SCOTUS AND THE DRUG INDUSTRY — Members of the POLITICO Pro health care team host a May 29 discussion on the pending Supreme Court ruling on “reverse payment” settlements. Panelists include Ralph Neas, president and CEO of the Generic Pharmaceutical Association, and David Certner, AARP policy director. Registration info: http://politi.co/11IaWqo

WHAT WE'RE READING, by Kathryn Smith

In an opinion piece in The Wall Street Journal, Sen. Lamar Alexander (R-Tenn.) compares HHS Secretary Kathleen Sebelius and her outreach to stakeholders about the health care law’s rollout to Oliver North and Iran-Contra. http://on.wsj.com/13JF0MD

Per the Los Angeles Times, UnitedHealth, Aetna and Cigna aren’t going to be part of California’s health exchange — but Kaiser Permanente and Anthem Blue Cross and Blue Shield of California, which are bigger players in the California market, will participate. http://lat.ms/11ZW1YM\

Massachusetts lawmakers are fighting to hold on to the health care law’s Medicare bonus payments to the state’s hospitals — known as the “Bay State boondoggle” — but are facing stiff opposition from other members of Congress. The Boston Globe story: http://b.globe.com/186dqQJ

As the state’s legislative session winds down, the Oklahoma state Senate passed a bill that would effectively defund Planned Parenthood on Wednesday, and the House is set to vote on it Thursday, the Huffington Post reports. http://huff.to/12NHsnz

The New York Times’s Well blog has a look at a new study that finds the elderly are less likely to be impacted by flu pandemics. http://nyti.ms/12Nz7Aq

Slate discusses the changes in the recently-released version of Diagnostic and Statistical Manual of Mental Disorders, which have sparked debate within the autism community. http://slate.me/16Pwh2M

** A message from Pfizer Helpful Answers: For more than 25 years, Pfizer has been a trusted resource for patients by providing prescription assistance to millions of Americans in need. In the last five years (2008-2012), Pfizer Helpful Answers helped more than 3.4 million uninsured and underinsured patients get access to more than 39 million Pfizer prescriptions, equaling more than $6.5 billion. As health care evolves in 2013 and beyond, Pfizer will continue to adapt the program to meet the changing needs of patients.

Pfizer Helpful Answers is a joint program of Pfizer Inc and the Pfizer Patient Assistance Foundation™. **